Author:
Nichols Vivien P.,Ellard David R.,Griffiths Frances E.,Underwood Martin,Haywood Kirstie L.,Taylor Stephanie J. C.,Nichols Vivien,Griffiths Frances,Achana Felix,Carnes Dawn,Eldridge Sandra,Hee Siew Wan,Higgins Helen,Mistry Dipesh,Mistry Hema,Newton Sian,Norman Chloe,Padfield Emma,Patel Shilpa,Petrou Stavros,Pincus Tamar,Potter Rachel,Sandhu Harbinder,Stewart Kimberley,Matharu Manjit,
Abstract
Abstract
Background
Between 2015 and 2019 the Chronic Headache Education and Self-management Study (CHESS) developed and tested a supportive self-management approach that aimed to improve outcomes for people with chronic migraine or chronic tension type headache with/without episodic migraine. However, a paucity of qualitative research which explored the lived experiences of people with chronic headache was evidenced. In response, we undertook to explore the experiences of living with chronic headaches of people who participated in the CHESS study.
Methods
We adopted qualitative methodologies, inviting participants in the CHESS study to participate in semi-structured interviews. In phase 1 (feasibility study), a thematic analysis was conducted. In phase 2 (main CHESS trial), interviews were informed by topic guides developed from our learning from the phase 1 interviews. Pen portrait methodology and thematic analysis was employed allowing us to explore the data longitudinally.
Results
Phase 1, 15 interviews (10 female) age range 29 to 69 years (median 47 years) revealed the complexities of living with chronic headache. Six overarching themes were identified including the emotional impact and the nature of their headaches. Phase 2, included 66 interviews (26 participants; median age group 50s (range 20s-60s); 20 females. 14 were interviewed at three points in time (baseline, 4 and 12 months) Through an iterative process four overlapping categories of headache impact emerged from the data and were agreed: i) ‘I will not let headaches rule my life’; ii) ‘Headaches rule my life’; iii) ‘Headaches out of control—something needs to change’; and iv) ‘Headaches controlled—not ruling my life’. One of these categories was assigned to each pen portrait at each timepoint.
The remaining 12 participants were interviewed at two time points during a year; pen portraits were again produced. Analysis revealed that the headache impact categories developed above held true in this sample also providing some validation of the categories.
Conclusions
These data give an insight into the complexities of living with chronic headache. Chronic headache is unpredictable, permeating all aspects of an individual’s life; even when an individual feels that their headache is controlled and not interfering, this situation can rapidly change. It shows us that more work needs to be done both medically and societally to help people living with this often-hidden condition.
Trial registration
ISRCTN79708100
Funder
National Institute for Health and Care Research
Publisher
Springer Science and Business Media LLC